Background: Cadmium exposure was found to cause a decline in lung function among the general
population, but these findings were limited to smokers and gender differences were not explored.
Objectives: To examine the relationship between cadmium and chronic obstructive pulmonary disease
(COPD) according to gender and smoking status in Korea.
Methods: Cross-sectional data from the Korean National Health and Nutrition Examination Survey from
2008 to 2011 were analyzed. COPD was defined by a pre-bronchodilator forced expiratory volume in 1 s
divided by forced vital capacity of o0.70. A logistic regression model was used to elucidate the
association between blood cadmium levels and COPD according to gender and smoking status.
Results: Among 3861 eligible participants, 3622 were included in the analysis. The prevalence of COPD
demonstrated an increasing trend in males (P for trendo0.001), but not in females (P for trend¼0.67).
After adjusting for covariates, a higher blood cadmium level, but within the normal range, was associated
with COPD in males, including those who had never-smoked (P for trend o0.001 and P for
trend¼0.008). However, a higher blood cadmium level was not significantly associated with COPD in
females, including those who had never smoked (P for trend¼0.39 and P for trend¼0.43).
Conclusions: A higher blood cadmium level, within the normal range, was associated with COPD in
males, including those who had never smoked. However, there was no significant association between
blood cadmium levels and COPD in females.